Mid-Term Results of EVAR in Severe Proximal Aneurysm Neck Angulation

Abstract

Mid-term outcomes following EVAR with the Endurant Stent Graft were not influenced by severe proximal neck angulation in our population. Despite the conformability of the device, moderate aortic neck remodeling was identified in the group of patients with angulated neck anatomy on the first computed tomography scan after implantation with no important further remodeling afterwards. No device integrity failures were encountered.

Select early type IA endoleaks after endovascular aneurysm repair will resolve without secondary intervention

“…Recent data suggest that type IA endoleaks may not carry such a dire prognosis as previously believed. Several studies have demonstrated low rates of rupture and aneurysm-related mortality and high rates of spontaneous sealing in select patients, [8][9][10][11][12][13][14] but these studies are limited by small numbers and limited follow-up. The goal of this study was to examine our institutional experience with type IA endoleaks in an effort to document long-term outcomes.…”

Proximal Aortic Neck Progression: Before and After Abdominal Aortic Aneurysm Treatment

“…Additionally, no correlation between the dilatation of proximal and distal landing levels is observed (14). Concerning changes in the neck angle between the preoperative condition and the immediate postoperative condition, data show that there is no clear relationship found between only the angle of the neck and proximal stent-graft migration (46, 47). Especially in large AAAs, we have found that there is a 15% increase in neck angulation and a 27% decrease in neck length after EVAR, compared to small AAAs, with no difference in outcome (48).…”

Repair of abdominal aortic aneurysms: preoperative imaging and evaluation

“…Unfavorable neck angulation greater than 60 degrees has been considered to be a contraindication to EVAR, although recent studies using more modern, conformable endografts have demonstrated the efficacy of EVAR treatment in patients with unfavorable neck angulation without significant differences in primary or secondary outcomes of EVAR 4 years out (21,(45)(46)(47). Further long-term results with these modern endograft devices are still ongoing (47).…”

“…Further long-term results with these modern endograft devices are still ongoing (47). Proximal neck diameter must also be quantified in order to provide proper stent oversizing.…”